2012 National HIV/AIDS and Aging Awareness Day Event Registration

Please take a few moments to complete the following NHAAAD Event pre-registration form. The registration will take less than 5 minutes of your time. We thank you in advance for registering your NHAAAD event. A complete list of events will be featured on The AIDS Institute's NHAAAD Website: www.NHAAAD.org.

What is the primary audience for your event? (Please check ALL that apply)

People living with HIV/AIDS (PLWHA’s) who are aging with the disease or already over 50 at the time of their initial diagnosis.

Increasing percentage of the population that needs to protect itself from HIV infection, including the growing baby boomer population.

Increasing number of grandparents becoming the primary guardians for children who have lost their parent(s) to HIV/AIDS.

Other:

This is a required question

Secondary Audience

If there is a secondary audience, please indicate it below. (Examples include: churches, senior centers, assisted living facilities, grandparents and grandchildren.)

This is a required question

Anticipated # of attendees

0-50

51-99

100-199

200-499

500+

This is a required question

Additional Attendee Information

(Please check ALL that apply)

The event is open to the public.

The event has a limited number of participants due to funding requirements.

Other:

This is a required question

Will onsite HIV testing be provided?

Yes

No

This is a required question

Please include any additional information about your event.

If you would like to upload a flyer or provide a link to your event, contact Michelle Scavnicky at MScavnicky@TheAIDSInstitute.org.

This is a required question

Thank you for taking the time to fill out this form.

Event listings will be featured on The AIDS Institute's NHAAAD website: www.NHAAAD.org as registrations are received. This is also a great resource for collaboration and ideas.
Also, we are interested in posting photos from your event, so don't forget your camera!